Summary

Welcome to Module III where the speakers illustrate important aspects in the management of the respiratory diseases in the framework of the treatable traits approach.

Prof. José Roberto Jardim from the Federal University of São Paulo, Brazil, chaired the session devoted to the emerging TT roles in chronic respiratory diseases of chronic mucous hypersecretion/mucous plugs and of social inequalities and deprivations in less developed countries and degraded communities in more affluent countries. Prof. Ian M. Adcock from the UK developed the first theme; Prof. Carlos Robalo Cordeiro from the University of Coimbra, Portugal, the second one.

Chronic mucus hypersecretion is a proxy of the disease activity — more persistent mucous hypersecretion means more FEV₁ lost — while mucous plugs in medium- to large-size airways are independent predictors of COPD severity, bacterial exacerbations, and early all-cause mortality. On the related chronic bronchitis theme, Prof. Marc Miravittles of the Hospital Universitari Vall d’Hebron in Barcelona highlighted the association between mucous hypersecretion and compromised mucociliary clearance and airway inflammation, higher sputum levels of proinflammatory cytokine, and persistent bacterial colonisation. Mucous hypersecretion and thickening are also detectable in Pre-COPD and Early COPD.

Prof. Borja G Cosío of Hospital Universitari Son Espases, Palma de Mallorca, concluded the session with some examples of non-pharmacological TTs associated with increased hospital admissions, readmissions, and mortality, such as poor physical activity and poor education to therapeutic indications.